Soliciting Provider Buy-in

Provider buy-in represents an essential component in developing pay-for-performance systems. When planning for a pay-for-performance system, states must remember that providers are their customers and take steps to actively engage them in setting targets, developing feedback reports and determining the frequency of incentive payments. By involving providers in the design of a pay-for-performance system, a state or other payer has the opportunity to use a vetting process for proposed measures and incentives to determine that the measure is clinically appropriate, reasonable, fair and easy to collect, and that the proposed incentive is financially meaningful to the provider.

Once the system is designed, state should consider pilot testing with a core set of providers continues to build on the NIATx principles of rapid-cycle change. The piloting might take place in several ways:

• Involve only a core set of providers
• Allow providers input into or opportunities to review contract changes
• Hold the providers harmless for improvement changes (good or bad) for the first six months

This approach allows a state or other payer to rehearse the system before introducing it state- or system-wide.